The magazine said a total of 19 out of more than 200 NHS clinical commissioning groups (CCGs) - which organise and pay for the majority of health services in local areaa - were ordered by NHS England to cut their budgets to help the health service make £22 billion in savings by 2020.

Among the CCGs which have adopted restrictions are NHS Basildon and Brentwood, which capped the number of vasectomy referrals GP practices can make, and NHS Mid Essex, which has a "restriction policy" on acupuncture, spinal injections and hip and knee operations during 2015/16.

According to Pulse, those with mild hearing loss in the NHS North Staffordshire area will no longer be provided with hearing aids, which campaigners have labelled as "cruel".

Until we get new funding into the NHS we will continue to come under financial pressure and it will get worse

Dr Richard Vautrey

Two CCGs, NHS Luton and NHS Great Yarmouth and Waveney, require smokers to give up cigarettes and obese patients to lose weight before being referred for hip and knee replacement surgery.

And NHS North East Essex - which faces a £22m funding shortfall - is restricting vasectomies, female sterilisation and spinal physiotherapy.

Dr Gary Sweeney, chair of North East Essex, told the magazine: "We have no choice other than to stay within budget.

"If we do not implement these decisions we will have to select other services to restrict."

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Dr James Kingsland, president of the National Association of Primary Care, called the policies "unacceptable" but Dr Michael Dixon, chairman of NHS watchdog, NHS alliance, said CCGs "are caught between a rock and a hard place".

Dr Richard Vautrey, deputy chair of the General Practioners Committee, said financial pressure is often hidden.

He added: "Where patients may have waited three months, they now wait six - this sort of thing is difficult to measure.

"Until we get new funding into the NHS we will continue to come under financial pressure and it will get worse."

The survey asked family doctors if additional restrictions had been placed on their CCG in the last 12 months, with 36 per cent answering "yes", 42 per cent responding "no" and a further 22 per cent saying they did not know.

Research by the King's Fund think-tank found operations carried out as day surgery, as opposed to staying overnight, had saved the NHS about £2 billion.